MRCOG EXAM - Mnemonics for MRCOG

Mnemonics in Obstetrics & Gynaecology

Assessment of pain

OLD CAA RTS

Management of Atonic Obstetric Haemorrhage-"HAEMOSTASIS"

General medical management

H-call for help

A-assess (vital signs/blood loss) & resuscitate

E-Establish aeitiology(4T-Tone/Tissue/ Trauma/Thrombin)

E-Ecbolics(syntometrine/ergometrine/bolus syntocinon)

E-Ensure availability of blood products

M-Massage the uterus

O-Oxytocin infusion,prostaglandins(intravenous,rectal,intramuscular,intramyometrial)

Specific surgical management

S-shift to operating theatre(bimanual compression anti-shock garment,especially if tranfer is required

T-Tissue & trauma to be exculded & balloon tamponade or uterine packing

A-apply compression sutures

S-sytematic pelvic devascularisation(uterine,ovarian,quadruple,internal iliac)

I-interventional radiology,uterine artery embolisation

S-Subtotal/Total hysterectomy

Source:

	Mukherjee S, Arulkumaran S. Post-partum haemorrhage. Obstetrics, Gynaecology & Reproductive Medicine. 2009 5;19(5):121-126.

Breaking bad news-"SPIKES" protocol

S-SETTING UP the Interview

P-ASSESSING THE PATIENT'S PERCEPTION

I-OBTAINING THE PATIENT'S INVITATION

K-GIVING KNOWLEDGE AND INFORMATION TO THE PATIENT

E-ADDRESSING THE PATIENT'S EMOTIONS WITH EMPATHIC RESPONSES

S-STRATEGY AND SUMMARY

article on breaking bad news

another resource on breaking bad news

Book:Mnemonics for Medical Students

Clinical Governance-"SPARE IT"

S-staffing

P-patient involvement

A-audit

R-research & risk management

E-effectiveness

I-information

T-teaching/Training

HELLP syndrome-a complication of preeclampsia

H-haemolysis

EL-elevated liver enzymes

LP-low platlets

HELPER-mnemonic for management of shoulder dystocia

      H-Help
      E-Evalute for an episiotomy (not necessarilyy done at this point)
      L-Legs (McRobert's- flexing the thighs up onto the maternal abdomen)
      P-Pressure (suprapubic)
      E-Enter (internal manoeurves- Wood Screw)
      R-Remove posterior arm
      R-Roll onto hands and knees

This is the recommended emergency drill from Advance Life Support Obstetrics (ALSO).

Interpretation of CTG DRCM BRAVADO

DR-Determine RISK

C-Contractions

M-Movements(fetal)/Meconium

BR-Baseline rate

A-Acceleration

VA-Variability

D-Deceleration

O-Overall

Interpretation of CTG-another mnemonic-"DARTH VADER"

D-Details(name,parity)

A-Assess quality(rate of paper-in U.K 1cm/min)

R-recorded fetal movements

T-tocography

H-Heart rate

V-Variabilty

A-Acceleration

D-Deceleration

E-Evaluation

R-Response

source:

Mnemonic for decelerations

"HELP VC"

HE-Head compression causes Early deceleration

LP-Late deceleration due to Placental insufficiency

VC-Variable deceleration due to Cord compression

Causes of transient urinary incontinence-DIAPPERS

Delirium

Infection

Atrophic vaginitis

Pharmaceuticals

Psychological problems

Excess urine output

Restricted mobility

Stool impaction

Postpartum haemorrhage-4T

T-Tone(atnonia)

T-Tissue(retained placenta)

T-Trauma

T-Thrombin(coagulation disorders)

FORCEPS/VACUUM DELIVERY

      A - Address the patinet/Anaesthesia/Assistance( anaesthetist, colleague,paediatrician)
      B- Bladder empty
      C- Cervix fully dilated/Contractions
      D- Determine position/Think and prepare for shoulder Dystocia
      E- Explain to the patient/ Exit plan if it fails, ready for cesarean section/check Equipment
      F - Fontanelle ( to check position )
      G - Gentle traction
      H- Handle elevated for forceps/Halt for vacuum ( no descent with 3 pulls, 3 times pop off )
      I - Incision/Episiotomy
      J- remove forceps when Jaw visible

Criteria for instrumental delivery- FORCEPS

F-favourable head position(OA/OP)

O-os fully dilated

R-rutpture the membranes

C-contractions

E-fully engaged head

P-adequate maternal pelvis

S-Stirrups(Lithotomy)

Antepartum haemorrhage causes

A-Abruption of placenta

P-Placenta praevia(or vasa praevia)

H-Haemorrhage from genital tract(ectropian/polyp/cervical cancer)

factors determining the outcome of labour

P-Power of uterine contractions

P-Passage/Pelvis

P-Passenger(size & position of fetus)

Ectopic pregnancy risk factors-"ECTOPIC"

E-Ectopic(past history)/Endometriosis

C-Contraception-IUCD,POP

T-Tubal surgery(sterilisation)

O-other surgeries(laparotomy/appendicetomy)

PID-pelvic inflammatory disease

I-infertility treatment

C-can't find-idiopathic

From:S.Yosuf & M.Choudry.Many more excellent mnemonics in:

Mnemonics for Medical Undergraduates

Oral contraceptive complications: warning signs ACHES:
   Abdominal pain
   Chest pain
   Headache (severe)
   Eye (blurred vision)
   Sharp leg pain

more mnemonics

Apgar

A - appearance (color)

P - pulse (heart rate)

G - grimmace (reflex, irritability)

A - activity (muscle tone)

R - respiratory effort

The five W's--post-operative fever

Wind--pneumonia, atelectasis

Water--urinary tract infection

Wound--wound infections

Wonderdrugs--especially anesthesia

Walking--walking can help reduce deep vein thromboses and pulmonary embolus

more mnemonics

Postpartum collapse: causes "HEPARINS"
      Hemorrhage
      Eclampsia
      Pulmonary embolism
      Amniotic fluid embolism
      Regional anaethetic complications
      Infarction (MI)
      Neurogenic shock

Septic shock

more mnemonics

Domestic violence screening:"SAFE"

      S-Stress and safety
Do you feel safe in your relationship? What happens when you and your partner disagree?
      A-Afraid or abused
Have you or your children ever been physically threatened or abused? Have you ever been forced to have sexual intercourse?
      F-Friend or family awareness
Are your friends or family aware of what is happening? Would they support and help you?
      E-Emergency escape plan
Are you in danger now, and would you like to go to a shelter or talk with someone? Do you have a place where you and your children could go in an emergency?

source

Mechanism of labour

                  "Don't Forget I Enjoy Really Expensive Equipment":
                                             Descent
                                             Flexion
                                             Interal rotation
                                             Extension
                                             Restitution
                                             External rotation
                                             Expulsion

source

postnatal examination:"BUBBLES"

B-Breast
U-Uterus
B-Bowel
B-Bladder
L-Lochia
E-Episotomy

S-Surgical site (for Cesarean section)

causes of secondary amenorrhoea-"SOAP"

S-Stress

O-OCP

A-Anorexia

P-Pregnancy

more mnemonics contributed by excellent users:here

Intrauterine infections:"TORCHS"

T-Toxoplasmosis

O-Other(parvo virus)

R-Rubella

C-cytomegalovirus

H-Herpes

S-syphilis

Jaundice at 24 hours of age-"RAGS"

R-Rhesus incompatibility

A-ABO incompatibility

G-G6PD deficiency

S-Spherocytosis

some more mnemonics

Chat with V. Ravimohan

Causes of increased alfa fetoprotein:

"Increased Maternal Serum Alpha Feto Protein"

Intestinal obstruction
Multiple gestation

Miscalculation of gestational age

Myeloschisis

Spina bifida cystica

Anencephaly

         Abdominal wall defect
         Fetal death
         Placental abruption

by Rinku Uberoi UNIBE

Female pelvis: shapes
                  "GAP"
                         In order from most to least common:
                                 Gynecoid
                                 Android /Anthropoid
                                 Platypelloid

Medical mnemonics for your PDA

Predisposing Conditions for Pulmonary Embolism: "TOM SCHREPFER"
         T--trauma
         O--obesity
         M--malignancy
         S--surgery
         C--cardiac disease
         H--hospitalization
         R--rest (bed-bound)
         E--estrogen, pregnancy, post-partum
         P--past hx
         F--fracture
         E--elderly
         R--road trip